当前位置： SCI文献检索 > CORONARY ARTERY DISEASE期刊下所有文献 > Invasive assessment of microvascular function in patients with valvular heart disease.

Invasive assessment of microvascular function in patients with valvular heart disease.

Abstract：

BACKGROUND:The aim of this study was to investigate microvascular function in patients with valvular heart disease (VHD), which causes chronic left ventricular volume and/or pressure overload, therefore change in coronary microvascular hemodynamics. PATIENTS AND METHODS:We prospectively enrolled 30 patients with VHD considered for surgery (10 aortic stenosis, 12 aortic regurgitation, and eight mitral regurgitation) and 30 controls. Intracoronary physiological assessments were performed in the unobstructed left anterior descending artery using a pressure-temperature sensor guidewire at rest and hyperemia. RESULTS:The index of microcirculatory resistance (IMR) was similar between the two groups (16.2±6.5 vs. 16.2±8.5, P=0.997), whereas coronary flow reserve (CFR) was lower in the VHD group compared with the controls (3.2±1.4 vs. 4.3±1.7, P=0.005). Resting and hyperemic coronary distal pressure, and hyperemic mean transit time were similar between VHD and controls, whereas resting mean transit time was significantly shorter (0.70±0.29 vs. 0.89±0.39, P=0.035) and baseline resting microvascular resistance was significantly lower in the VHD group compared with the controls (58.1±25.4 vs. 78.1±36.7, P=0.011). Patients with aortic stenosis showed numerically higher IMR values than aortic regurgitation, mitral regurgitation, and controls, although this was not statistically significant (20.4±6.9, P=0.14). CFR was significantly correlated with log high-sensitivity cardiac troponin T levels in patients with VHD (r=-0.523, P=0.004). CONCLUSION:CFR was reduced in patients with VHD compared with controls, despite similar microvascular function as assessed by IMR. This appeared to be mainly because of an increased resting coronary flow accompanied by a decreased resting coronary microvascular resistance rather than microvascular disease.

journal_name

Coron Artery Dis

journal_title

Coronary artery disease

authors

Nishi T,Kitahara H,Saito Y,Nishi T,Nakayama T,Fujimoto Y,Matsumiya G,Kobayashi Y

doi

10.1097/MCA.0000000000000594

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

223-229

issue

eissn

0954-6928

issn

1473-5830

journal_volume

pub_type

杂志文章

在线工具

Invasive assessment of microvascular function in patients with valvular heart disease.